Review articleClinical microbiologySpontaneous C. septicum gas gangrene: A literature review☆
Section snippets
Introduction, background, microbiology
Gas gangrene, or clostridial myonecrosis, which invariably evokes images of the battlefield and warfare, is a necrotizing infection of muscle caused by anaerobic bacteria, namely C. perfringens, C. novyi and C. septicum; although other pathogenic clostridial species are also known to cause this devastating disease. The source of infection is most commonly an infected wound resulting from a deep penetrating or crushing injury, which provides an anaerobic milieu for growth of bacteria [1]. With
Pathogenesis of spontaneous C. septicum infection
C. septicum is an opportunistic pathogen in humans. It usually gains access through the gastrointestinal tract from a site of mucosal defect. Bacterial swarming is a multicellular behavior which involves differentiation of cells into hyperflagellated swarm cells, which are capable of undergoing rapid and coordinated movements across solid and viscous surfaces. It is common among flagellated bacteria, including Salmonella, Vibrio, Yersinia, Serratia, and Proteus and C. septicum. In vitro studies
Clinical spectrum of spontaneous C. septicum infection
The clinical spectrum of spontaneous C. septicum is variable and can present as skin and soft tissue infection, abscess, neutropenic enterocolitis, or sepsis [22]. In a 1989 review of 162 cases by Kornbluth, 81% of patients with C. septicum infection were found to have an associated malignancy, 34% with colorectal carcinoma, and 40% with a hematological malignancy [6]. Skin and soft tissue infection ranging from cellulitis to life threatening gas gangrene constitute the most common
Diagnosis and management
The diagnosis and management of spontaneous C. septicum gas gangrene pose serious challenges due to various factors: patients at extremes of age, nonspecific symptoms, coexisting illness and rapid fulminating course with signs and symptoms of shock within hours of presentation. Diagnosis is mainly clinical though radiological findings of gas in affected area can suggest gas gangrene. A gram stain from the wound tissue or aspirate from bullae shows numerous large gram positive bacilli [4].
Review of C. septicum spontaneous gas gangrene literature
C. septicum is not a normal human inhabitant and disease occurrence is related to certain host factors which either increase the colonization rates and invasiveness of the bacteria in gastrointestinal tract or cause an enhanced susceptibility to the infection, or both. To identify these risk factors, the authors did a PubMed search for all the published cases using the keywords ‘clostridium septicum,’ ‘gas gangrene,‘ and ‘clostridial myonecrosis’ and identified 94 cases of spontaneous gas
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Clostridium septicum myonecrosis following gardening: A case report
2023, International Journal of Surgery Case ReportsSystematic literature review and meta-analysis of Clostridium septicum aortitis
2022, Journal of Vascular SurgeryCitation Excerpt :In this systematic review, we provide a full census of all cases with C septicum-associated aortitis published in the literature that consists of single case reports and small case series only. Evaluation of the most relevant review articles published in the last years regarding this topic (eg, Lehman et al in 2020, Srivastava et al in 2017, or Alimi et al in 2017) revealed our results to plausibly complement the existing English language literature supporting accurateness of our search algorithms.2,4,57 Up to now, this rare but extremely lethal disease, which requires early and reliable interdisciplinary treatment to pave the way for the possibility of long-time survival, lacks guidelines owing to the low number of cases (n = 72) published in the literature.
Prospects of conservative treatment for Clostridium septicum–associated aortitis
2022, Journal of Vascular Surgery Cases, Innovations and TechniquesIn the shadow of the pandemic
2022, Enfermedades Infecciosas y Microbiologia ClinicaRapidly progressive and fatal distant spontaneous gas gangrene due to Clostridium septicum after biopsy of malignant cecal mass
2021, IDCasesCitation Excerpt :Clostridium perfringens and Clostridium septicum are well known members of this family to cause these necrotizing infections. Whereas Clostridium perfringens often causes trauma associated, Clostridium septicum infections are usually spread hematogenously and can cause fatal spontaneous gas gangrene without associated trauma and have a unique association with colon cancer [1,2]. Clostridium septicum possesses several unique characteristics which enables it to cause this clinical syndrome.
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This material is based upon work supported in part by the U.S. Department of Veterans Affairs, Office of Research and Development Biomedical Laboratory Research Program.